I'm getting my mom ready for medicaid over the next few years. I was a little nervous so I'm reaching out to a lawyer now and not waiting till assets are exhausted. My biggest worry is I'm paying for an aid and worry that the payments will be questioned, as well as food bills and the like
Do not pay money to have an attorney fill it out for you as this would be a complete waste. By time someone needs Medicaid they have almost no assets. Info required is usually, Legal name, DOB, SSN, address; then copies of recent checking/savings account statements; listing of any properties or physical assets like a home or car; and the prior 3 months worth of her medical bills. You don't need to show the titles or deeds (at least where I live I didn't need to).
Make sure the certified elder law attorney has plenty of experience with Medicaid. If you are not your Mom's PoA right now, I would have her assign you as her Durable PoA (so no diagnosis of impairment is required). You will have to have a very clear paper trail of what you are paying for so that nothing appears as "gifting" to Medicaid, or money she is reimbursing you ditto. This is a discussion with the attorney and you need to follow it to the T.
I have been engaged in long distance caregiving for my now 99-year old aunt in NYC since 2009, when we first executed the POA and Healthcare Proxies (just in case) and I arranged Meals on Wheels for her. Her needs obviously increased gradually and then more dramatically over the years. In 2021, I first arranged part-time home health aides (through NY Department of Aging). Those hours increased to more full-time after she fell and broke her arm and I had to bring in private agency help - very expensive and the money was flowing out. I kept detailed records of all the money I paid out for everything.
I had looked into the Medicaid LTC process, but initially put off applying due to the spend-down rules (that don’t include retirement funds from what I recall). My aunt was adamant about remaining in her rented apartment so I was initially looking into MLTC. I had spoken with two separate attorneys and their prices were outrageous considering I would actually be doing all of the work.
Time went on and I was about to begin the process. Then she had several embolic strokes in 9/2023. Following hospitalization she went to Rehab and then to the nursing home. She did fully recover however my aunt understood she could not go home due to the cost of FT care and the fact we were so low on money.
I did the Medicaid application (5-year look back) and submitted it through the nursing home business office. It was time-consuming on my end gathering and collating all of the paperwork, etc., but not that painful. My paperwork included ALL of the funds paid out for home health aides but if memory serves, it did NOT require details of groceries and miscellaneous items I purchased. And I purchased ALL of her items for several years. PRIOR to submission to Medicaid/the Nursing Home, we DID purchase the prepaid funeral trust. As others have noted, After submission you cannot use funds for that.
In summary, I’m not sure any of this helps you but here’s the thing - Like you, I have been overseeing every aspect of my aunt’s care and needs for years. I have been paying her bills, and have been a signer on her checking and investment accounts for years. Every penny spent from those accounts has been for her welfare and benefit. Knowing that takes all the *fear* out of the Medicaid application filing. You likely have done the same, which can give you peace through the process.
Feel free to send me a message if you’d like.
Warmly,
JB
I had the same worry because we paid cash out of pocket. Our lawyer told me to make a spreadsheet of the amount of cash that was spent each month and on what. We didn't have receipts for any of the money laid out, my mother just insisted giving out $100 bills. I was so worried that my father's application would be denied and he'd been in the nursing home for 6 months as Medicaid pending before it finally went through. Just a lot of worry.
His application went through, it took awhile but nothing was questioned. I hope that makes you feel a little better. I understand how stressful this is.
One suggestion, if you need to spend down assets, you can create funeral trusts for you, any siblings and sibling's spouses. We had to do that when we applied for my mother so that we could spend down the rest of her assets. Not sure if that is helpful in your situation, but it was for us.
Hang in. ((hugs)).
I am very glad you will be seeing the attorney.
Be certain to include preplanned funeral services, and such. You will get a lot of guidance with an elder law attorney and will check that all documents are in place.
Be certain to include in plan of care the circumstances of how often you and mom will evaluate that living together (especially if this is in your home) is working for you BOTH and what circumstances will lead to placement in care.
I am assuming you are already her POA. If not, all of your documents and etc and formation of your solid files needs to be done ASAP. Your mother pays for this.
PS looking on the forum I see you have several notes to us, firsttimer. And truth is that your mom may be too advanced now to form a good contract of care with you and an attorney, so it is all the more crucial that you see an attorney for advice. There may be still time, but very little of it.